This adorable 12-14 year old rescue pup presented today for collapsing off of the vehicle seat. He was completely normally up until today. The owner assumed he was being dramatic because he HATES going to the groomer. But, much to our surprise he was NOT being dramatic and was dealing with a VERY SERIOUS condition.
Normally, Boo puts up quite the fight at the vet but today was different. He was very weak and panting a lot. His gums were incredibly pale. I put my stethoscope up to his chest and all I could hear was lung sounds. I moved my stethoscope around but no heart beat could be heard. Next, I checked his pulses in his back legs. They were also absent!
Boo was still relatively stable despite his weakness. We immediately took him to get chest xrays (see picture) and pulled blood to run bloodwork. His bloodwork was relatively normal other than high blood sugar from the stress. However, the X-rays were not normal. His heart was very large and round (see picture). I was suspicious as to what was going on but needed to confirm with ultrasound. Just as I thought, the sac the surrounds his heart (pericardial sac) was filled with fluid (see video)! This fluid was putting a lot pressure on the heart. We call this cardiac tamponade. We hooked him up to a machine that showed us his heart rhythm. This was also NOT NORMAL. With this much pressure, the heart cannot pump to its full ability and the body is not able to get enough oxygen/blood. We HAD to get rid of this fluid so the heart can pump normally again.
We gave Boo a bit of pain medication, supplemented oxygen, cleaned and froze the area, and drained 35mls of fluid from around the heart (see video). Within minutes, I was able to hear Boos heart again. His heart rhythm returned to normal and his oxygenation increased.
Boo spent the rest of the day with us. I did another ultrasound a few hours later (see video) to ensure the fluid was still gone before sending him home to Old Macdonald Kennel. He is coming back tomorrow and intermittently for the next few weeks for repeat ultrasounds. Old MacDonald Kennels & Animal Services.
CAUSES -Idiopathic (arises spontaneously) -Structural heart disease -Cancer/ tumor on heart -Toxin ingestion -Trauma
CLINICAL SIGNS -Acute collapse/ weakness -Difficultly breathing (dyspnea) -Pale gums -Inappetence -Increased heart rate, abnormal rhythm, and/or muffled heart sounds -Weak pulses
DIAGNOSIS -Clinical signs above -Xrays: globoid heart +/- fluid in lungs, abnormal chest vessels, poor detail in abdomen -Ultrasound: fluid in pericardial sac +/- heart tumour
TREATMENT -Removal of fluid in heart sac (pericardiocentesis) and recurrent removal as needed -Long term treatment involves treatment of the primary cause
PROGNOSIS -Depends on cause of fluid -If fluid comes back quickly (hours to days) then prognosis is very poor